Livingston County Road Commission 3535 Grand Oaks Drive Howell, Michigan 48843

(517) 546-4250 Fax: (517) 546-9628

COMMERCIAL WAIVER APPLICATION

PLEASE FILL IN INFORMATION IN BOTH SECTIONS AND PROVIDE ONE COPY OF A SITE PLAN

APPLICANT INFORMATION NAME:

CURRENT ADDRESS:

CITY, STATE, ZIP CODE:

TELEPHONE:

FAX NUMBER:

SITE INFORMATION NAME OR TYPE OF DEVELOPMENT:

NAME OF PRIVATE ROAD OR EXISTING COMMERCIAL DRIVEWAY LOCATED ON:

COUNTY ROAD LOCATED OFF OF:

NEAREST COUNTY ROAD:

TOWNSHIP: SECTION NO.:

DATE:

REASON FOR WAIVER:

Private Road Joint Driveway Demolition/Replace

Change in Use Addition to Building/Facility

Other (please explain):